Does exercise reduce knee pain from meniscus degeneration?

From the Guidelines

Exercise is a clinically effective treatment for reducing knee pain from meniscus degeneration, with benefits comparable to oral non-steroidal anti-inflammatory drugs and paracetamol, as shown in a recent network meta-analysis of 152 randomised controlled trials 1. When considering exercise as a treatment option, it's essential to note that individuals with more severe pain and poorer physical function at baseline tend to benefit more from exercise, with the greatest benefits seen in those with baseline pain scores around 40 out of 100 1. Some key points to consider when implementing an exercise program for knee pain from meniscus degeneration include:

• Low-impact exercises like swimming, cycling, and walking are beneficial for strengthening the muscles around the knee without excessive joint stress
• Aim for 30 minutes of low-impact activities 3-5 times per week, gradually increasing intensity as tolerated
• Specific strengthening exercises for the quadriceps, hamstrings, and hip muscles should be performed 2-3 times weekly with 8-12 repetitions per set
• Gentle stretching of the calves, hamstrings, and quadriceps helps maintain flexibility
• Weight management through exercise can also decrease pressure on the knee joint, with each pound lost reducing knee load by four pounds
• If pain increases during exercise, reduce intensity rather than stopping completely, and consider using proper footwear, applying ice after activity, and taking over-the-counter anti-inflammatories like ibuprofen (400-600mg every 6-8 hours with food) to manage discomfort 1.

From the Research

Exercise and Knee Pain from Meniscus Degeneration

• Exercise therapy is a recommended first-line treatment for degenerative meniscal tears, with studies showing significant improvements in knee pain and function 2, 3, 4.
• A 12-week exercise therapy program has been shown to improve neuromuscular function and muscle strength in middle-aged patients with degenerative meniscus tears, with benefits maintained at 1-year follow-up 4.
• Physical therapy, including stretching and strengthening exercises, can reduce medial meniscal extrusion and improve knee pain and range of motion in patients with knee osteoarthritis 5.
• A meta-analysis of randomized controlled trials found that arthroscopic partial meniscectomy combined with medical exercise therapy was effective in reducing pain and improving range of motion in the early postoperative period, but found no significant differences in long-term outcomes compared to isolated medical exercise therapy 6.

Key Findings

• Exercise therapy can improve knee pain and function in patients with degenerative meniscal tears 2, 3, 4.
• Physical therapy can reduce medial meniscal extrusion and improve knee pain and range of motion in patients with knee osteoarthritis 5.
• Arthroscopic partial meniscectomy combined with medical exercise therapy may be recommended for the treatment of degenerative meniscal tear, but further research is necessary to determine the best exercise program 6.

Exercise Programs

• A progressive exercise therapy program aimed at improving neuromuscular function and muscle strength has been shown to be effective in patients with degenerative meniscus tears 4.
• A standardized home exercise program that addresses major muscle groups can be used in conjunction with in-clinic physical therapy to improve knee function in patients with degenerative meniscal tears and concomitant OA 3.